Ever wonder what other physicians are thinking about the recent changes in healthcare? Rest assured, your colleagues are probably having the same reactions, thoughts, doubts as you!
A new survey from The Commonwealth Fund and The Kaiser Family Foundation of 1,624 primary care physicians and 525 midlevel clinicians (namely nurse practitioners and physician’s assistants) captured provider reactions on how the Affordable Care Act (ACA) and other rising healthcare trends are affecting their practices.
Where do you and your practice fit in? Read on to see what the surveyed providers said!
Changes to Primary Care Reimbursements
Thanks to the ACA, the shift from fee-for-service to more value-based models has sped up. According to the survey, 64% of primary care physicians said they are paid by either capitation or salary or through a combination of capitation, salary, and fee-for-service.
[tweetme text="Just over one-third of primary care physicians still earn income exclusively from fee-for-service payments."]
How about incentives for providing high-quality care? Just over half of the surveyed physicians (55%) said they receive additional payments for quality of care or patient experiences or for utilization or efficiency in care.
Accountable Care Organizations and Medical Homes
Love them or leave them, ACA has also brought about new models of delivering care ¾ including accountable care organizations (ACOs), patient-centered medical homes (PCMHs), and advanced primary care practices (APCP). About 29% of physicians reported participating in an ACO arrangement with Medicare or private insurers, and a similar 30% said they have received incentives or payments for qualifying as a PCMH or through a ACPC medical home demonstration.
[tweetme text="29% of physicians are part of an ACO"]
More than one-quarter of physicians were unsure if their practices qualify as ACOs. If you’re part of that percentage, you may want to find out if you qualify!
Physicians clearly have mixed feelings about whether ACOs work. 26% of surveyed providers said ACOs had a negative impact on quality of care, nearly double the amount who said they had a positive impact (14%)!
For those already participating in ACOs, 30% reported a positive impact, 24% said a negative impact, and 20% found no impact at all.
The results showed similar mixed feelings about the value of PCMHs. One-third of physicians said they think PCMHs improve their ability to provide high-quality patient care, while only 14% reported a negative impact. However, a surprising 26% said PCMHs have had no impact! Another 27% of physicians said they were unsure of medical homes’ impact.
But for practices already receiving incentives or payments for qualifying as a PCMH or APCP, 43% viewed medical home programs as a positive thing.
How do Physicians View Payers?
This probably comes as no surprise, but physicians did not have very high opinions of any payers! The percentage of physicians rating any insurer “excellent” overall was in the single digits.
When rating payers by physician reimbursement, physicians rated private payers higher (46% gave “excellent” or “good” ratings), than Medicare (21%) or Medicaid (11%). The same trend was true for ease of administration ¾ 32% physicians gave private payers excellent or good ratings, ahead of 25% for Medicare and 16% for Medicaid.
How do physicians feel about healthcare technology?
While a majority of providers see technology as helpful, many physicians are still reluctant to admit its benefits. Half of physicians rated the increased use of health information technology as having a positive impact on their ability to provide quality care to their patients. On the other hand, 28% said it’s had a negative impact, and 10% reported no impact.
Can medical practices remain independent?
17% of physicians said their practices were acquired or consolidated with a group practice, hospital, or other organization within the past two years. This was especially true for primary care providers, though specialists saw the trend as well.
This trend is increasing in part because small practices are encountering high administrative burden and operating costs, and hospitals have figured out ways to absorb the costs of hiring high-salaried physicians. As Modern Healthcare puts it “the welcome influx of paying patients from healthcare reform, efficiencies associated with hospital consolidation and the continued improvement in the overall economy,” are all feeding this trend.
Thinking about retiring early? You’re not alone. [tweetme text="Almost half of physicians surveyed said they were considering early retirement due to recent trends in healthcare."]
On the other hand, nearly one in five physicians said that recent trends are causing them to consider delaying their retirement. About one-third of physicians said the trends aren’t impacting their retirement plans either way.